Tissue cutting and retrieval device and method

ABSTRACT

A device for cutting and retrieving tissue, including a handle having a tube, a first set of wires positioned within the tube and extending from the handle to distal ends, and a control tip secured to the distal ends. A second set of wires are positioned within the tube and extend from the handle, through a slot in the control tip, to coupled distal ends. A retaining pin is secured to the control tip, extends between at least two of the second set of wires, allows the second set of wires to be extended from the tube and through the control tip, and prevents the second set of wires from being withdrawn from the control tip and into the tube. The retaining pin also extends the second set of wires from the tube upon the first set of wires being extended from the tube.

CROSS-REFERENCE TO RELATED APPLICATIONS

[0001] The present application claims priority to provisional U.S.patent application serial No. 60/322,763, filed on Sep. 17, 2001, whichis assigned to the assignee of the present application and incorporatedherein by reference.

FIELD OF THE INVENTION

[0002] This invention generally relates to a surgical instrumentassembly for use in cutting and retrieving objects from internal bodycavities and, more specifically, to a surgical instrument assembly foruse in snare cauterization procedures. The present invention alsorelates to a method for cutting and retrieving objects from internalbody cavities and, in a preferred form, to a method for cutting,capturing and/or retrieving polyps and other aggregates of organictissue from a patient's internal organs via a snare cauterizationprocedure.

BACKGROUND OF THE INVENTION

[0003] A wire snare has been used in many different configurations andfor many different medical uses. The snare, when equipped for use withcautery, has been used for polypectomies. For example, during acolonoscopy, or other endoscopic procedures, a wire loop or snare,combined with cautery, is frequently used to biopsy or excise lesions.While a wire loop or snare is very effective at cutting free a lesion,it has substantially no ability to capture and/or retrieve the excisedlegion.

[0004] Typically, a second instrument is used to retrieve the excisedlesion. The second instrument most often is provided in the form of awire basket having several loops perpendicular to each other anddesigned to trap the excised lesion, such as a stone basket used inurology and gastroenterology. The use of two different instruments, oneinstrument to cut and a second instrument to retrieve, however, isinconvenient, inefficient, time consuming and can sometimes lead to theloss of the excised lesion.

[0005] What is still desired is a single instrument that can snare andretrieve a lesion. Preferably, the instrument will be simple in designand reliable in use, and will allow repeated use of a snare or aretrieval configuration, as required, by simple mechanical means.

SUMMARY OF THE INVENTION

[0006] The present invention provides a simple, but elegant solution tothis problem by providing a device for selectively capturing, cuttingand retrieving tissue, wherein the device includes a cutting snare, orcauterization wires, that can be incorporated into a retrieval basketconfiguration also including a basket snare, or basket wires, withoutremoving the cutting snare from a patient's body. It also allowsrepeated use of the basket or the snare configuration, as required, bysimple mechanical means.

[0007] According to one aspect of the present invention, the deviceincludes a handle having an elongated, flexible tube extending therefromalong a central axis to a distal end, a first set of elongated, flexiblewires slidingly positioned within the tube and extending along thecentral axis from the handle to distal ends for extending out of thedistal end of the tube, a control tip secured to the distal ends of thefirst set of wires, the control tip having a slot, and a second set ofelongated, flexible wires slidingly positioned within the tube andextending along the central axis from the handle, through the slot inthe control tip, to distal ends, the second set of wires coupled at thedistal ends. A retaining pin is secured to the control tip and extendsthrough the slot of the control tip and between at least two of thesecond set of wires. The retaining pin allows the distal ends of thesecond set of wires to be extended through the control tip, and preventsthe coupled distal ends of the second set of wires from being withdrawnfrom the slot of the control tip and into the tube. In addition, theretaining pin extends the distal ends of the second set of wires fromthe distal end of the tube upon the distal ends of the first set ofwires being extended from the distal end of the tube.

[0008] According to one aspect of the present invention, the first setof wires includes two wires. According to another aspect, the second setof wires includes two wires.

[0009] According to an additional aspect of the present invention, thecontrol tip is secured to the first set of wires and the slot of thecontrol tip is oriented such that a first reference plane formed by atleast two of the wires of the first set and a second reference planeformed by at least two of the wires of the second set are angularlyoffset. According to a further aspect, the first reference plane issubstantially perpendicular to the second reference plane.

[0010] According to still another aspect of the present invention, thewires have shape memory such that each of the first and the second setsof wires expand upon being extended from the distal end of the tube.According to an additional aspect, each of the first and the second setsof wires expand to an oval loop upon being extended from the distal endof the tube.

[0011] According to a further aspect of the present invention, thedevice includes a first deployment assembly operatively connected to thefirst set of wires and allowing a user to selectively extend andwithdraw the distal ends of the first set of wires from the distal endof the tube, and a second deployment assembly operatively connected tothe second set of wires and allowing a user to selectively extend andwithdraw the distal ends of the second set of wires from the distal endof the tube. According to another aspect, a latching mechanism isprovided for connecting the first and second deployment assemblies. Inaccordance with an additional aspect, a locking mechanism is providedfor preventing movement of the first deployment assembly.

[0012] The present invention also provides a method for selectivelycapturing, cutting and retrieving tissue in a body cavity using a deviceas defined above. The method includes inserting into the body cavity thedistal end of the elongated, flexible tube, and manipulating the secondset of wires from the handle so that distal ends of the second setextend from the distal end of the tube and capture tissue to be cutbetween at least two wires of the second set. A cauterizing current isthen applied to the second set of wires such that the tissue is cut, andthe first set of wires is manipulated from the handle so that the distalends of the first set of wires and the control tip extend from thedistal end of the tube and capture the cut tissue between the first andthe second sets of wires. The distal end of the tube, together with thefirst and the second sets of wires and the cut and captured tissue, issubsequently withdrawn from the body cavity.

[0013] These and other features and benefits of the presently discloseddevice and method will become more apparent upon reading the followingspecification in combination with the accompanying drawing figures.

BRIEF DESCRIPTION OF THE DRAWINGS

[0014]FIG. 1 is a side elevation view of an exemplary embodiment of adevice constructed in accordance with the present invention forselectively capturing, cutting and retrieving tissue;

[0015]FIG. 2 is a top plan view of a first set of (or “basket”) wiresand a control tip of the device of FIG. 1;

[0016]FIG. 3 is a side elevation view, partially in section, of thefirst set of wires and the control tip of the device of FIG. 1;

[0017]FIG. 4 is a sectional view of the first set of wires and thecontrol tip of the device of FIG. 1, taken along line 4-4 of FIG. 2;

[0018]FIG. 5 is a side elevation view of a second set of (or“cauterization”) wires of the device of FIG. 1;

[0019]FIG. 6 is an enlarged side elevation view of the first set ofwires extending out of a tube of the device of FIG. 1, the control tippositioned adjacent a distal end of the tube, and the second set ofwires extending out of the tube and through the control tip; and

[0020]FIG. 7 is a flow chart illustrating a method according to thepresent invention for selectively capturing, cutting and retrievingtissue preferably using the exemplary device of FIG. 1.

[0021] Like reference characters designate identical or correspondingcomponents and units throughout the several views.

DETAILED DESCRIPTION OF AN EXEMPLARY EMBODIMENT

[0022] Referring first to FIG. 1, there is shown an exemplary embodimentof a device 10 constructed in accordance with the present invention forselectively capturing, cutting and retrieving tissue from within aninterior cavity of a patient. The device 10 generally includes a handle12 having an elongated, flexible tube 14 extending therefrom along acentral axis 16 to a distal end 18.

[0023] A first set of elongated, flexible wires 20 is slidinglypositioned within the tube 14 and extends along the central axis 16 fromthe handle 12 to distal ends 22 extending out of the distal end 18 ofthe tube 14. The first set of wires 20 is also shown in FIGS. 2, 3 and6. A control tip 24 is secured to the distal ends 22 of the first set ofwires 20, as also shown in FIGS. 2, 3, 4 and 6. A second set ofelongated, flexible wires 28 is slidingly positioned within the tube 14and extends along the central axis 16 from the handle 12, through a slot26 in the control tip 24, to distal ends. The slot 26 of the control tip24 is shown best in FIGS. 3,4 and 6. The second set of wires 28 iscoupled at the distal ends 30, as shown in FIGS. 5 and 6.

[0024] A retaining pin 32 is secured to the control tip 24 and extendsthrough the slot 26 of the control tip 24 and between at least two wiresof the second set of wires 28. The retaining pin 32, which is shown bestin FIGS. 2, 3 and 6, allows the distal ends 30 of the second set ofwires 28 to be extended through the control tip 24, and prevents thecoupled distal ends 30 of the second set of wires 28 from beingwithdrawn from the slot 26 of the control tip 24 and into the tube 14.In addition, the retaining pin 32 extends the distal ends 30 of thesecond set of wires 28 from the distal end 18 of the tube 14 upon thedistal ends 22 of the first set of wires 20 being extended from thedistal end of the tube 14.

[0025] In the exemplary embodiment shown in the drawings, the first setof wires 20 includes two wires, and the second set of wires 28 includestwo wires. It shown be understood, however, that the first and secondsets of wires 20, 28 can each be provided with more than two wires. Thewires are formed of a thin spring or shape metal which allows the wiresto completely collapse and be retracted into the tube 14 and expand uponbeing extended from the distal end 18 of the tube 14. Preferably, eachof the first and the second sets of wires 20, 28 are formed such thatthey each expand to an oval loop upon being extended from the distal endof the tube 14, but can be formed to expand to other shapes, such as aspiral shape. The first and the second sets of wires 20, 28 are formedfrom shape-memory metals such as stainless steel and nitinol, which have“memory” or the ability to retain their original shape when extendedfrom the tube 14. The sets of wires 20, 28 can utilize hollow or solidextensions 34 from the handle 12, and can either pass side by sidethrough the tube 14, or one extension can extend through the otherextension (such as hypotube) for more accurate approximation.

[0026] The control tip 24 is secured to the first set of wires 20 andthe slot 26 of the control tip 24 is oriented such that a firstreference plane formed by at least two of the wires of the first set 20and a second reference plane formed by at least two of the wires of thesecond set 28 are angularly offset. Preferably, the control tip 24 holdsthe two sets of wires 20, 28 such that the first reference plane issubstantially perpendicular to the second reference plane, so that thewires form a desired “retrieval basket” when both sets of wires 20, 28are extended as shown in FIG. 1. The tube 12, the control tip 24 and thepin 32 can each be made of stainless steel or Teflon® or other suitablematerial.

[0027] Referring to FIG. 1, the handle 12 of the device 10 includes afirst deployment assembly 36 operatively connected to the first set ofwires 20 and allowing a user to selectively extend and withdraw thedistal ends 22 of the first set of wires 20 from the distal end 18 ofthe tube 14, and a second deployment assembly 38 operatively connectedto the second set of wires 28 and allowing a user to selectively extendand withdraw the distal ends 30 of the second set of wires 28 from thedistal end 18 of the tube 14. The handle 12 also includes a latchingmechanism 40 that allows a user to latch the first and second deploymentassemblies 36, 38, such that movement of one assembly causes movement ofboth assemblies, e.g., when the device 10 is being used as a retrievaltool. In addition, the handle 12 is provided with a locking mechanism 42that allows a user to prevent movement of the first deployment assembly36 during operation of the second deployment assembly 38, e.g., when thedevice 10 is being used as a cutting tool. In this manner, the device 10can be simply configured for cutting and retrieval without removing thedevice 10 from an internal body cavity of patient. Although not shown,the device 10 includes a connector for connecting the second set ofwires 28 to a source of power, e.g., cauterizing current, for energizingthe second set of wires 28 so that the wires cut tissue captured withinthe second set of wires 28.

[0028] Referring to FIG. 7, the present invention also provides a method50 for selectively capturing, cutting and retrieving tissue in a bodycavity using the device 10 of FIGS. 1 through 6. The method 50 includesinserting into the body cavity the distal end of the elongated, flexibletube 14, as shown at “A”, and manipulating the second set of wires 28from the handle 12 so that distal ends 30 of the second set 28 extendfrom the distal end 18 of the tube 14 and capture tissue to be cutbetween at least two wires of the second set 28, as shown at “B”. Acauterizing current is then applied to the second set of wires 28 suchthat the tissue is cut, as shown at “C”, and the first set of wires 20is manipulated from the handle 12 so that the distal ends 22 of thefirst set of wires 20 and the control tip 24 extend from the distal endof the tube 14 and capture the cut tissue between the first and thesecond sets of wires 20, 28, as shown at “D”. The distal end 18 of thetube 14, together with the first and the second sets of wires 20, 28 andthe cut and captured tissue, is subsequently withdrawn from the bodycavity, as shown at “E”.

[0029] The present invention, accordingly, provides a device and amethod which allows a single instrument to function as a tissue cuttingsnare and a basket retriever. By replacing two or more existinginstruments with a simply manufactured and easily utilized device, thepresent invention beneficially provides a useful, new and improveddevice and method for endoscopically cutting and retrieving tissue.

[0030] Modifications to the above-described exemplary embodiment of thepresently disclosed invention may become apparent to those skilled inthe art. The scope of the invention is therefore intended to be limitedsolely by the scope of the appended claims.

1. A device for selectively capturing, cutting and retrieving tissue,comprising: A) a handle having an elongated, flexible tube extendingtherefrom along a central axis to a distal end; B) a first set ofelongated, flexible wires slidingly positioned within the tube andextending along the central axis from the handle to distal ends forextending out of the distal end of the tube; C) a control tip secured tothe distal ends of the first set of wires, the control tip having aslot; D) a second set of elongated, flexible wires slidingly positionedwithin the tube and extending along the central axis from the handle,through the slot in the control tip, to distal ends, the second set ofwires coupled at the distal ends; and E) a retaining pin secured to thecontrol tip and extending through the slot of the control tip andbetween at least two of the second set of wires, the retaining pinallowing the distal ends of the second set of wires to be extendedthrough the control tip, and preventing the coupled distal ends of thesecond set of wires from being withdrawn from the slot of the controltip and into the tube, the retaining pin extending the distal ends ofthe second set of wires from the distal end of the tube upon the distalends of the first set of wires being extended from the distal end of thetube:
 2. A device according to claim 1, wherein the first set of wiresincludes two wires.
 3. A device according to claim 1, wherein the secondset of wires includes two wires.
 4. A device according to claim 1,wherein the control tip is secured to the first set of wires and theslot of the control tip is oriented such that a first reference planeformed by at least two of the wires of the first set and a secondreference plane formed by at least two of the wires of the second setare angularly offset.
 5. A device according to claim 4, wherein thefirst reference plane is substantially perpendicular to the secondreference plane.
 6. A device according to claim 1, wherein the wireshave shape memory such that each of the first and the second sets ofwires expand upon being extended from the distal end of the tube.
 7. Adevice according to claim 6, wherein each of the first and the secondsets of wires expand to an oval loop upon being extended from the distalend of the tube.
 8. A device according to claim 1, wherein the retainingpin is unitarily formed as part of the control tip.
 9. A deviceaccording to claim 1, further comprising: F) a first deployment assemblyoperatively connected to the first set of wires and allowing a user toselectively extend and withdraw the distal ends of the first set ofwires from the distal end of the tube; and G) a second deploymentassembly operatively connected to the second set of wires and allowing auser to selectively extend and withdraw the distal ends of the secondset of wires from the distal end of the tube.
 10. A device according toclaim 9 further comprising a latching mechanism for connecting the firstand second deployment assemblies.
 11. A device according to claim 9further comprising a locking mechanism for preventing movement of thefirst deployment assembly.
 12. A method for selectively capturing,cutting and retrieving tissue in a body cavity, comprising: A) insertinga distal end of an elongated, flexible tube into the body cavity, theflexible tube extending from a handle and having, a first set ofelongated, flexible wires slidingly positioned within the tube andextending from the handle to distal ends, a control tip secured to thedistal ends of the first set of wires, the control tip having a slot, asecond set of elongated, flexible wires slidingly positioned within thetube and extending from the handle, through the slot in the control tip,to distal ends, the second set of wires coupled at the distal ends, anda retaining pin secured to the control tip and extending through theslot of the control tip and between at least two of the second set ofwires; B) manipulating the second set of wires from the handle so thatthe distal ends of the second set extend from the distal end of the tubeand capture tissue to be cut between at least two wires of the secondset; C) applying a cauterizing current to the second set of wires suchthat the tissue is cut; D) manipulating the first set of wires from thehandle so that the distal ends of the first set of wires and the controltip extend from the distal end of the tube and capture the cut tissuebetween the first and the second sets of wires; and E) withdrawing thedistal end of the tube, together with the first and the second sets ofwires and the cut and captured tissue, from the body cavity.
 13. Amethod according to claim 12, wherein the first set of wires is providedwith two wires.
 14. A method according to claim 12, wherein the secondset of wires is provided with two wires.
 15. A method according to claim12, wherein the control tip is secured to the first set of wires and theslot of the control tip is oriented such that a first reference planeformed by at least two of the wires of the first set and a secondreference plane formed by at least two of the wires of the second setare angularly offset.
 16. A method according to claim 15, wherein thecontrol tip is secured to the first set of wires and the slot of thecontrol tip is oriented such that the first reference plane issubstantially perpendicular to the second reference plane.
 17. A methodaccording to claim 12, wherein the wires are provided with shape memorysuch that each of the first and the second sets of wires expands uponbeing extended from the distal end of the tube.
 18. A method accordingto claim 17, wherein the wires are provided with shape memory such thateach of the first and the second sets of wires expands to form an ovalloop upon being extended from the distal end of the tube.
 19. A methodaccording to claim 12, wherein the retaining pin is unitarily formed aspart of the control tip.
 20. A method according to claim 12, wherein thefirst set of wires is locked in position prior to manipulation of thesecond set of wires.
 21. A method according to claim 12, whereinproximal ends of the first and the second sets of the wires areconnected together prior to withdrawal of the wires from the bodycavity.